Purpose <p>Intense pulsed light (IPL) therapy is an approach to ameliorate meibomian gland dysfunction (MGD). A novel IPL system for the treatment of MGD is the LacryStim device. The aim of this study is to investigate the safety and efficacy of the LacryStim device in patients with MGD.</p> Methods <p>This study was conducted in a prospective, randomized, intra-individual sham-controlled, double-masked design. Three treatment visits and three study visits at baseline and after three and six months were performed. The randomized study eye (SE) was treated using 8&#xa0;J/cm². The contralateral control eye (CE) was sham-treated with 1&#xa0;J/cm². The primary outcome was the mean difference of meibum quality and expressibility between SEs and CEs at the six months visit.</p> Results <p>Fifty eyes of 25 patients were included in the study. While no significant differences between both groups regarding meibum quality and expressibility could be detected at the six months visit, there was a tendency towards better expressibility in both groups after six months (SEs: − 0.4, <i>p</i> = 0.07; CEs: − 0.4, <i>p</i> = 0.04). Additionally, a significant improvement in numeric rating scale in both eyes and OSDI score (both <i>p</i> &lt; 0.05) at all follow-up visits and no device-related adverse events were observed.</p> Conclusion <p>To our knowledge this is the first prospective evaluation of a novel IPL device. There was a significant amelioration of subjective complaints and a tendency towards better expressibility in both study and control eyes. An intra-individual design might compound the individual analysis of either eyes in studies investigating IPL.</p> <p>ClinicalTrials.gov Identifier: NCT05089591.</p>